Kornimate/medical-research-clean huggingface dataset:
epidural anesthesia-analgesia and long-term survival after lung cancer surgery

Conditions: Lung Cancer; Thoracic Surgery; Anesthesia, Epidural; Neoplasm Recurrence, Local; Neoplasm Metastasis

Summary: available studies suggest that regional anesthesia-analgesia may decrease the occurrence of recurrence/metastasis in patients after cancer surgery. however, evidences from prospective studies are still lacking. the purpose of this randomized controlled trial is to investigate the effect of epidural anesthesia-analgesia on recurrence-free survival in patients undergoing lung cancer surgery.

lung cancer is increasing and is the leading cause of cancer death. surgical resection is the mainstay of treatment for early stage non-small cell lung cancer. however, long-term survival after lung cancer surgery is far from optimal, and cancer recurrence or metastasis is the main reason leading to cancer death in these patients. the development of cancer recurrence/metastasis largely depends on the balance between tumor-promoting factors and immune function of the body. studies showed that surgical manipulation releases cancer cells into circulation; and stress response induced by surgery inhibits the cell-mediated immunity. in addition, volatile anesthetics and opioids may also aggravate immunosuppression and potentially worsen long-term outcome. on the other hand, regional anesthesia can blunt surgical stress and reduce anesthetic consumption. these effects may help to preserve immune function and reduce recurrence/metastasis. however, existing evidences are insufficient to draw conclusion in this topic. the purpose of this randomized controlled trial is to test the hypothesize that regional anesthesia-analgesia may reduce recurrence/metastasis and improve long-term survival in patients after lung cancer surgery.

Eligibility criteria:
inclusion criteria: 1. adult patients (aged 18-80 years); 2. clinically diagnosed as primary non-small cell lung cancer of stage ia to iiia, and scheduled for radical surgery; 3. agreed to receive patient-controlled analgesia after surgery. exclusion criteria: 1. distant metastasis, malignant tumor in other organs, or chemo-/radiotherapy or other anti-cancer therapy before surgery; 2. comorbid with autoimmune diseases, or glucocorticoid/immunosuppressant therapy within 1 year; 3. history of schizophrenia, epilepsy or parkinson disease, or unable to complete preoperative assessment due to severe dementia, language barrier, or end-stage disease; 4. severe hepatic disease (child-pugh classification c), renal failure (serum creatinine \>442 umol/l or receiving renal replacement therapy), or american society of anesthesiologists classification iv or higher; 5. history of anesthesia and/or surgery within 1 year; 6. contraindications to epidural anesthesia, including spinal deformity, coagulation dysfunction, local infection, and history of spinal trauma/surgery; 7. allergic to any medications used during the study.

Keywords: lung cancer surgical resection epidural anesthesia and analgesia cancer recurrence/metastasis long-term outcome
comparison of the in vivo stability of 2 cementless tka designs

Conditions: Knee Osteoarthritis

Summary: the goal of this randomized controlled trial is to analyze the stability of a cementless total knee arthroplasty (tka) over time and compare it to a well-documented implant in patients with knee osteoarthritis. the main aim is to answer if there is a difference in stability over time as a measure of long time survivorship in these 2 implants. 50 participants will be randomly allocated to receive either the triathlon tritanium (stryker) or the global medacta knee sphere (gmk sphere, medacta) 3d printed cementless tkas.

total joint replacement is an efficacious treatment for osteoarthritis of hips and knees. both tka and total hip artrhoplasties (tha) have excellent implant survivorship. however, patients' satisfaction is lower in tka than tha. a possible cause of the discrepancy is the unnatural knee kinematics after tka. various implants designs have been developed to solve the problem. the most common fixation mode is cemented tka with good survival up to 15 years. however, newer series in younger patients also have shown lasting survival with cementless implants (nilsson kg, prudhon jl). among various different designs, the medially stabilized total knee, which are designed to reproduce natural knee kinematics with a medial ball-in-socked design, is a promising implant design (no authors listed). dynamically the medial pivot knee performs more naturally (bragonzoni l,petersen et) compared to other designs. most data for this design is available only for the cemented version. up to now there is no safety study performed that confirms the stability over time for this implant with cementless fixation. in this study, the investigators will therefore analyze the in vivo stability of an uncemented tka with a medially stabilized design, and compare it with a well-documented comparable implant. in order to do this, the investigators will use the ct based micromotion analysis (broden c, broden c). this study will contribute to the understanding of fixation and lead to safety to the patient.

Eligibility criteria:
inclusion criteria: • patients referred to kristiansund hospital for primary total knee replacement surgery for osteoarthritis with kellgren \& lawrence grade 3 or 4 exclusion criteria: * preoperative severe deformity (hip-knee-ankle angle of \>5 (valgus) or \<-15 degrees (varus) on a full-length leg image at weight bearing * preoperative flexion contracture more than 15° * less than 50 and more than 75 years of age at the time of surgery * use of walking aids because of other musculoskeletal and neuromuscular problems * preoperative diagnosis other than osteoarthritis or avascular necrosis (e.g. rheumatoid arthritis, tumours) * revision arthroplasty * obesity with bmi\>35 g/m2 * lateral collateral ligament deficient knee * previous knee joint infection * cognitive dysfunction or severe psychiatric disorders.

Keywords: ct based micromotion analysis ctma cementless tka uncemented tka total knee replacement total knee arthroplasty tkr gmk sphere tritanium
effect of erythropoietin in refractory autoimmune encephalitis patients

Conditions: Autoimmune Encephalitis

Summary: this study evaluates the efficacy of erythropoietin in refractory autoimmune encephalitis. ten patients will receive 100 iu/kg of erythropoietin 3 times a week for 12 weeks.

erythropoietin can improve the refractory autoimmune encephalitis. erythropoietin has tissue-protective effect via activation of janus kinase (jak)-2, signal transducer and activator of transcription (stat)-5 pathway and nf-kappa b pathway. the activation of jak-2 and stat-5 promote hemoglobin synthesis and facilitate cell cycle progression. also, nf-kappa b pathway inhibition regulates pro-inflammatory cytokine production. we expect that erythropoietin may lead to improve the symptoms and outcome of autoimmune encephalitis.

Eligibility criteria:
inclusion criteria: * clinically diagnosed autoimmune encephalitis * ineffective 1st line treatment (e.g. steroid iv, ivig) and 2nd line treatment (e.g. rituximab or cyclophosphamide) exclusion criteria: * hemoglobin \> 12g/dl * hematochrit \>36% * thrombocytosis \> 750k * ast or alt \> 120 * hiv (+) * allergic reaction upon erythropoietin * uncontrolled hypertension * mrs before the autoimmune encephalitis \> 3 * breast feeding or pregnancy * history of ischemic stroke or pulmonary thrombosis * refuse to be enrolled

Keywords: erythropoietin autoimmune encephalitis
botulinum toxin relieves anxiety, depression and sleep disorderes in patients with blepharospasm

Conditions: Blepharospasm

Summary: blepharospasm (bsp) is a chronic, idiopathic, recurrent and progressive disease, which mostly occurs in both eyes. it is mainly manifested as involuntary spasm of muscles around the eyes, leading to uncontrollable narrowing or even closure of blepharospasm. although there is no pain in bsp patients, it can cause social or psychological dysfunction, make patients feel difficult in driving, reading and working, and seriously affect the social, work and life of patients. depression and anxiety are common and harmful mental disorders. at present, less than 40% of patients with depression can get effective treatment. using simple and effective screening tools can effectively improve the detection rate of depression, so that patients can get timely and effective treatment. it is also an effective measure to prevent suicide. botulinum toxin type a (btx-a) has achieved gratifying results in the treatment of dyskinesia. it has been confirmed that btx-a has a significant effect on bsp. the effective rate is 70% - 90%. about 50% of the patients can regain normal or near normal visual function. at present, no prospective studies have explored this association between blepharospasm and depression / anxiety, and whether btx-a can improve this mood disorder. therefore, our research goal is to further study the relationship between blepharospasm and depression / anxiety, sleep in a prospective way, and to determine whether btx-a treatment will affect depression / anxiety symptoms, so as to provide more theoretical basis for clinical treatment.


Eligibility criteria:
inclusion criteria: * patients with blepharospasm who received botulinum toxin injection therapy * all patients must have had the symptoms of blepharospasm for over six months exclusion criteria: * glaucoma * age-related macular degeneration * visual acuity of 20/200 or worse * chronic obstructive pulmonary disease * cardio cerebral diseases, psychosis * loss of limb * connective tissue diseases * dialysis dependence * anyone who was unable to cooperate with the examinations
saline irrigation reduces the residual bile duct stones during endoscopic retrograde cholangiopancreatography (ercp)

Conditions: Stone Clearance

Summary: the purpose of this study was to evaluate the usefulness of saline solution irrigation in decreasing residual common bile duct (cbd) stones.

in recent years, ercp is the standard procedure to remove the bile duct stones. the big stones(\>1.2 cm) require additional lithotripsy procedures for complete stone removal. nevertheless, small stone fragments still remain in the common bile duct when the cholangiogram shows normal. the fragments are too small to be verified. these retained fragments may cause recurrence of stones. another way to demonstrate residual cbd stones is to use intraductal ultrasonography (idus). however, idus has limited availability in clinical practice. the single-operator cholangioscopy (soc)-system spyglass gains widespread acceptance because of its independent washing channels and direct viewing. the investigators used spyglass to detect if saline(50 or 100ml) infusion might clear the bile duct fragments after ercp. saline irrigation has many advantages such as easy stone removal, no additional cost and rare side effects. the purpose of this study is to evaluate the usefulness of saline solution irrigation in decreasing residual cbd stones.

Eligibility criteria:
inclusion criteria: * ercp common bile duct stone patients were able to provide written informed consent; * size of stone large than 1.2 cm. exclusion criteria: * unwillingness or inability to consent for the study; * coagulation dysfunction (inr\> 1.5) and low peripheral blood platelet count (\<50×10\^9 / l) or using anti-coagulation drugs; * previous ercp; * prior surgery of bismuth ⅱ, roux-en-y and cholangiojejunostomy; * preoperative coexistent diseases: acute pancreatitis, gi tract hemorrhage or perforation, severe liver disease(such as decompensated liver cirrhosis, liver failure and so on), septic shock; * biliary-duodenal fistula confirmed during ercp; * pregnant women or breastfeeding; * presence of intrahepatic duct stone; * malignancy.

Keywords: ercp common bile duct stone cholangitis residual stone irrigation
effect of intermittent hemodialysis on sleep apnea syndrome in end stage renal disease patients

Conditions: Obstructive Sleep Apnea; Overhydration; End Stage Renal Disease

Summary: the purpose of this study is to investigate the effect of decreasing fluid overload by hemodialysis on the severity of obstructive sleep apnea, in patients with end stage chronic kidney disease on intermittent hemodialysis. it aims further to investigate the relationship between overhydration, nocturnal rostral fluid shift and the severity of sleep apnea.

obstructive sleep disordered breathing is more prevalent in end stage kidney disease patients than in the general population, and may participate to the increased cardiovascular mortality observed in this group of patients. despite a significant increase in knowledge about the harmful effects of obstructive sleep apnea, the pathophysiological mechanisms are poorly understood. recent observations suggest a causative relationship between overnight fluid displacement from the legs to the neck soft and the severity of obstructive sleep apnea. this mechanism was demonstrated in otherwise healthy subjects, in heart failure patients, and in patients with venous insufficiency. we thus suspect that this pathophysiologic mechanism could explain the increased prevalence of obstructive sleep apnea in patients with hypervolemia, including chronic renal failure. the purpose of this trial is to investigate the hypothesis that nocturnal rostral fluid ship is linked to overhydration and participates significantly to the severity of obstructive sleep apnea in patients on hemodialysis. the correction of overhydration by hemodialysis should therefore reduce the amount of nocturnally displaced water and consequently lower the severity of obstructive sleep apnea. the severity of obstructive sleep apnea is measured by two consecutive attended polysomnographies, performed before and after an ambulatory hemodialysis session with fluid removal, whereas overhydration and leg fluid are evaluated by bioimpedance, performed at the beginning and at the end of each polysomnography. the sequence of the two polysomnographies with respect to hemodialysis is randomized, to minimize the first-night effect.

Eligibility criteria:
inclusion criteria: * moderate to severe obstructive sleep apnea syndrome, with an apnea-hypopnea index (ahi) ≥ 15/h * age ≥ 18 years * patient with end stage renal disease on chronic intermittent hemodialysis exclusion criteria: * unstable congestive heart failure * pace-maker * active psychiatric disease * amputation of the lower limbs, proximal to the ankle

Keywords: obstructive sleep apnea overhydration end stage renal disease intermittent ambulatory hemodialysis polysomnography bioimpedance leg fluid shift neck circumference
identification of clinically occult glioma cells and characterization of glioma behavior through machine learning analysis of advanced imaging technology

Conditions: Glioma

Summary: gliomas are one of the most challenging tumors to treat, because areas of the apparently normal brain contain microscopic deposits of glioma cells; indeed, these occult cells are known to infiltrate several centimeters beyond the clinically apparent lesion visualized on standard computer tomography or magnetic resonance imaging (mr). since it is not feasible to remove or radiate large volumes of the brain, it is important to target only the visible tumor and the infiltrated regions of the brain. however, due to the limited ability to detect occult glioma cells, clinicians currently add a uniform margin of 2 cm or more beyond the visible abnormality, and irradiate that volume. evidence, however, suggests that glioma growth is not uniform - growth is favored in certain directions and impeded in others. this means it is important to determine, for each patient, which areas are at high risk of harboring occult cells. we propose to address this task by learning how gliomas grown, by applying machine learning algorithms to a database of images (obtained using various advanced imaging technologies: mri, mrs, dti, and met-pet) from previous glioma patients. advances will directly translate to improvements for patients.

gliomas are the most common primary brain tumors in adults; most are high-grade and have a high level of mortality. the standard treatment is to kill or remove the cancer cells. of course, this can only work if the surgeon or radiologist can find these cells. unfortunately, there are inevitably so-called "occult" cancer cells, which are not found even by today's sophisticated imaging techniques. this proposal proposes a technology to predict the locations of these occult cells, by learning the growth patterns exhibited by gliomas in previous patients. we will also develop software tools that help both practitioners and researchers find gliomas similar to a current one, and that can autonomously find the tumor region within a brain image, which can save radiologists time, and perhaps help during surgery.

Eligibility criteria:
inclusion criteria: * must have histologically proven glioma * the patient or legally authorized representative must fully understand all elements of informed consent, and sign the consent form exclusion criteria: * psychiatric conditions precluding informed consent * medical or psychiatric condition precluding mri or pet studies (e.g. pacemaker, aneurysm clips, neurostimulator, cochlear implant, severe claustrophobia/anxiety, pregnancy)

Keywords: glioma machine learning advanced diagnostic imaging
apical pelvic support in infertility patients

Conditions: Infertility, Female; Pelvic Organ Prolapse; Pelvic Floor Disorders

Summary: this study aims to evaluate apical pelvic compartment support in infertility patients at the time of hysteroscopy. apical pelvic compartment evaluation for pelvic organ prolapse will be performed in infertility patients undergoing hysteroscopy.

the incidence of pelvic organ prolapse in the whole population has been demonstrated several times in previous studies. however, pelvic floor defects in young infertility patients are not known. in this study, a clinical pelvic floor assessment with the pelvic organ quantification system will be performed in infertility patients during standard physical examinations or hysteroscopy.

Eligibility criteria:
inclusion criteria: * ages between 18-45 * patients who cannot become pregnant despite regular sexual intercourse for more than one year exclusion criteria: * malignity * patients who become pregnant during infertility assessment

Keywords: pelvic organ prolapse infertility apical pelvic support
effect of general anesthesia on early postoperative cognitive function in cesarean section

Conditions: Anesthesia Morbidity; Cesarean Section Complications

Summary: cognitive dysfunction is the impairment of the mental process of perception, memory and information processing. the preoperative cognitive state is important, as mild cognitive impairment may be worsened following a cesarean section. our study will aim to assess the incidence of early cognitive dysfunction after elective and emergent cesarean section under general anesthesia.

mechanisms that lead to cognitive decline after anesthesia and surgery remain still unclear and mixed. some studies suggested that an important role is played by the immune response to surgery. the inflammatory response could contribute to the development of postoperative cognitive decline (pocd0 through secretion of cortisol, cytokines, and other inflammatory mediators. comparing the effects of general and spinal anesthesia on pregnant patients undergoing an elective cesarean section, found no cognitive change after both anesthesias. our observational comparative study will be carried out at beni suef university hospital. we will compare early cognitive functions undergoing general anesthesia in patients undergoing elective and emergency cesarean section.

Eligibility criteria:
inclusion criteria: * women in reproductive age period between 25 and 35 years * women booked for an elective or emergency cesarean section. exclusion criteria: * mental disorder preoperative * medical conditions ( as hypertension or diabetes or cardiac diseases)

Keywords: cognitive function postoperative
study of tl-895 combined with ruxolitinib in jaki treatment-naïve mf subjects and subjects with mf who have a suboptimal response to ruxolitinib

Conditions: Myelofibrosis; Primary Myelofibrosis; Post-PV MF; Post-ET Myelofibrosis

Summary: this study evaluates tl-895, a potent, orally-available and highly selective irreversible tyrosine kinase inhibitor for the treatment of myelofibrosis. participants must have mf (pmf, post pv mf, or post et mf) who are jaki treatment-naïve or those who have a suboptimal response to ruxolitinib.


Eligibility criteria:
inclusion criteria: subjects with suboptimal response to ruxolitinib: * treatment with at a stable dose of ruxolitinib prior to study entry * subjects ≥ 18 years of age and able to provide informed consent. * confirmed diagnosis of pmf, post-pv mf, or post-et mf, as assessed by treating physician according to the world health organization (who) criteria * high-risk, intermediate-2 risk, or intermediate-1 risk, defined by dynamic international prognostic system (dipss) * palpable spleen measuring ≥ 5 cm below the left lower coastal margin (llcm) or spleen volume of ≥ 450 cm3 by mri or ct scan assessment * eastern cooperative oncology group (ecog) performance status of 0 to 2 * adequate hematological, hepatic, \& renal function. exclusion criteria: treatment-naive subjects: * prior treatment with any jaki subjects with suboptimal response to ruxolitinib: * documented disease progression while on ruxolitinib treatment all subjects: * prior splenectomy or splenic irradiation within 24 weeks prior to first dose of study treatment * prior treatment with a btk or bmx inhibitor

Keywords: myelofibrosis
efficacy of the interferential laser therapy in pain reduction in carpal tunnel syndrome

Conditions: Carpal Tunnel Syndrome; Neuropathic Pain

Summary: the purpose of this study is to determine the efficacy of the interferential laser therapy in the wrist and hand pain and disability reduction and force improvement in the carpal tunnel syndrome. subjects are patients diagnosed of carpal tunnel syndrome who have been prescribed laser therapy. settings: ramon y cajal hospital. department of rehabilitation. physical therapy unit. electrotherapy section. occupational therapy. department of neurology.

the spatiotemporal superposition of two independent and opposite beams of laser generates a constructive interference pattern that increases the therapeutic effects in the irradiated tissue. patient suffering pain from diagnosed carpal tunnel syndrome will receive conventional or interferential laser therapy. this is a comparative randomized and double blind clinical study. two identical lasers in near infrared range will be used. frequency of sessions: daily. irradiated technique: manual, contact and punctual. pain will be evaluated by visual analog scale at rest and during analytical wrist movement. disability will be evaluated by the dash and boston questionnaire. evaluation will take place at pre and post-treatment times.

Eligibility criteria:
inclusion criteria: * patients diagnosed of carpal tunnel syndrome by means of an electromyography study. * patients with or not previous surgery. * patients with an age of 18 years or older. * patients having a signed informed consent. exclusion criteria: * patients with severe hand traumatisms. * patients with cervical radiculopathy. * patients with outlet thoracic syndrome. * patients bearing osteo syntheses material. * patients suffering tumoral pathology.

Keywords: carpal tunnel syndrome interferential laser therapy low-level laser therapy neuropathic pain median nerve compression